Introduction

10 Tips to Relieve Alzheimer's Sundowning

Carol Bradley Bursack Mar 14th, 2014 (updated May 29th, 2015)
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Many people who have Alzheimer’s disease experience times, generally as daylight fades and evening approaches, when their symptoms intensify. This phenomenon is called sundowning. It’s thought that sundowning stems from a combination of factors such as disorientation due to lack of light, fatigue and disruptions in the body clock. While there’s no cure for sundowning some medications and lifestyle changes can help. Below are some tips that may help you and your loved one cope with this often frustrating end-of-day behavior: 

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Full Spectrum Light
Full Spectrum Light

Talk with your loved one’s doctor about obtaining a full spectrum light such as the type used for seasonal affective disorder (SAD). The National Institutes of Health’s review of several studies found that exposure to increased light in the morning led to decreased agitation and confusion, improved sleep quality and better cognitive functioning for the person with Alzheimer’s disease. 

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Socializing and activity levels
Socializing and activity levels

Keeping a person with Alzheimer’s disease active can contribute to a more satisfying life. Adult day care can be helpful since activities can encourage elders to stay busy as well as socialize with peers. Since some people who suffer from sundowning feel anxious about something they feel that they must accomplish, having gone out to ADC can help them feel satisfied - as though they’ve come home from work. 

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Avoid caffeine especially after noon
Avoid caffeine especially after noon

This may seem obvious, but many drinks such as soft drinks and hot chocolate contain caffeine. Try to substitute decaffeinated products to limit the stimulant.

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Discourage too much napping
Discourage too much napping

Again, adult day care or other activities can help prevent napping out of boredom. It’s natural for anyone who has slept a great deal during the day to be wakeful at night. 

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Manage pain
Manage pain

People with Alzheimer’s often can’t self-report when it comes to pain. Work closely with the doctor to manage any pain so that relaxation is possible.  

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Offer frequent meals and snacks
Offer frequent meals and snacks

Older people often don’t digest large meals as efficiently as younger people, so light meals may ease digestion and stave off hunger. If your elder wanders at night, offering a snack may help him return to bed.  

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Control stress
Control stress

Keeping days as stress free as possible is helpful, however, as the evening draws near eliminating stress becomes even more important. In a busy family, or even in a busy nursing home, meal time can become noisy and upsetting to someone with AD. Do what you can to keep this time as quiet and serene as possible. 

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Develop and follow routines
Develop and follow routines

Most people with Alzheimer’s and many other dementias feel comforted by routines. While boredom is something you want to prevent, staying with a routine is reassuring.  

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Music
Music

Observe your elder to see how he or she responds to certain types of music. While the big band sound may be a wonderful way to get energized during the afternoon, perhaps some soft instrumental music is a better choice as the day comes to a close. Harp music is known to be particularly relaxing for elders and people with severe cognitive disabilities. There are CD's available. 

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Watch for personal triggers
Watch for personal triggers

Alzheimer's symptoms can vary from day to day. Over time you may see a pattern. Taking notes may help clarify these problem areas. This knowledge can help you determine if music is soothing or stimulating or additional light has a positive effect in the evening or simply makes your elder more anxious. Watch for personal triggers that can set off a bad night and try to eliminate what you can.